Patient Information Leaflet

Care of Your Humeral (Upper Arm) Fracture.

Produced By: Fracture Clinic

June 2013 Review due June 2015

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If you require this leaflet in another language, large print or another format, please contact the Quality Team, telephone 01983 534850, who will advise you.

The humerus, or upper arm is the second largest bone in the human body. Fractures of this bone can be divided in to three types, • The humeral head, which forms the ball of the shoulder joint. • The shaft. • The top part of the elbow joint. Your doctor will explain to you where in the humerus your fracture is.

Fracture Treatment The location and type of fracture you have will determine how our doctors treat your injury. Some humeral fractures may require surgical fixation which will be discussed with you in your consultation if it is required. The majority of humeral fractures are, however, best treated conservatively. This means that you fracture may be managed by: • The application of a “collar and cuff” type sling. • The application of a bracing cast, or plaster with a “collar and cuff”.

The aim of this treatment is to ensure that the upper arm remains hanging, allowing the weight of the arm to provide natural traction to the fracture, maintaining an acceptable position.

Pain relief . These are very painful injuries and you should take regular pain relief. If you are unsure about what pain killers are safe for you to take, please discuss it with the orthopaedic doctor during your appointment, or with your GP.

Immobilisation. It is important to ensure that the upper arm remains hanging all the times to keep the fracture in the correct position. Keep it in the collar and cuff and do not rest your elbow on cushions, pillows or chair arms for example, as this will move the shoulder up. The sling must be the only support for your arm.

Resting any cast or splint on a hard surface such as a chair arm can lead to the rubbing and tearing of the skin inside the splint or cast and may result in a pressure sore . Should you develop sore skin or a wound under a cast or splint you should seek advice as soon as possible using the contact numbers below.

Dressing. You should keep your arm close to your body and avoid movement as much as possible until your doctor advises you to start moving. You should wear your collar and cuff at all times and put your clothes on over the arm and sling. Ladies may find a bra difficult and painful to wear. Some ladies find a strapless bra more comfortable.

Sleeping. You should sleep upright, either in an arm chair, or sitting up in bed propped up on plenty of pillows. Your upper arm should be allowed to hang and not be rested on pillows which may force your shoulder upwards.

Hygiene. You should not get slings, splints or casts wet unless the Plaster Room staff have specifically told you otherwise. With one arm immobilised it may be difficult and dangerous

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to get in and out of the bath, and so this should be avoided. It is important to keep your under arm, bend in the elbow and under ladies breasts as clean and dry as possible to prevent skin infections. Baby wipes are useful for washing these areas. When washing the under arm lean slightly to the injured side and this will make a space between the body and arm without moving the shoulder joint.

Moving the arm. It is important to keep moving your wrist and fingers to prevent swelling and stiffness. You can use a soft ball or rolled up pair of socks in your hand to squeeze. The elbow becomes stiff very quickly if it is not moved, unless advised otherwise or in a cast, you should remove your forearm from the collar and cuff four times a day, and whilst leaving the upper arm hanging, bend and straighten the elbow several times.

Follow Up. You will be seen regularly in clinic to check how your injury is healing.

If you have any problems with your splint or cast in between appointments then please call the Plaster Room between 8.30am and 1pm Monday to Friday on 01983 822099 x6656. Outside of these hours please call the Island Health Line on 111.

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Valuables should not be brought into the hospital. If patients have to bring in valuable items they should ask a nurse to store them safely and request a receipt for the items. You may not be able to have the valuable items returned if the time of discharge from hospital is out of hours.

We are sorry but the Trust cannot accept responsibility for loss or damage to items not given for safe keeping.

You can get further information on all sorts of health issues through NHS interactive available through Sky TV or online at: http://www.nhsdirect.nhs.uk/

For Health advice and out of hours GP service please call the NHS 111 service on: 111

We Value Your Views On Our Service

If you wish to comment on the care which you, your relative or friend has received, we will be pleased to hear from you. Please speak to the person in charge of the ward, clinic or service in the first instance or ask them to contact the Quality Team. If you wish to contact them directly, telephone on 534850.

Alternatively you may prefer to write to:

Chief Executive Isle Of Wight NHS Trust St Mary’s Hospital Newport Isle of Wight PO30 5TG

You can also share any concerns you have about our services with the Care Quality Commission (CQC) on 03000 61 61 61 or at [email protected]

All NHS sites are no smoking areas. If you would like help and advice to stop smoking please call: Freephone 0800 169 0 169 to talk to the NHS Smoking Helpline.

Ref: OP/HF/01

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